2014: From uncertainty to confidence

Summing up a bumpy year, The Atlantic reported 2013 will “go down in history as one of the least predictable—and most political—years in history for American medical research.” We at Group Health Research Institute (GHRI) felt that uncertainty, unsure in early 2013 how sequestration and threats of government shutdown might harm our research, which is mostly federally funded. But we ended the year with confidence and hope for three reasons:

• Our external support has remained remarkably steady,thanks largely to renewed funding for work important to national priorities:
  • Our research continues in cancer screening, chronic illness, and GHRI’s Vaccine Treatment and Evaluation Unit—one of nine such facilities nationwide that the National Institutes of Health (NIH) supports to test vaccines against emerging diseases.
  • GHRI’s MacColl Center for Health Care Innovation leads Learning from Effective Ambulatory Practices (LEAP), with ongoing funding from the Robert Wood Johnson Foundation. Having identified high-performing primary care practices nationwide, LEAP is now helping these teams form learning communities to share their best work with others—lessons likely to prove valuable in this era of health reform.
  We’re also diversifying our funding beyond our traditional sources. Our work with the U.S. Food and Drug Administration (FDA)’s Mini-Sentinel Initiative, aimed at finding ways to monitor safety of medical products, grew in 2013, with GHRI scientists leading the Initiative’s methods development and specific projects. Our scientists also expanded their work for an Evidence-based Practice Center (EPC) funded by the Agency for Healthcare Research and Quality (AHRQ). With Kaiser Permanente, we’re producing evidence reviews for the Centers for Medicare & Medicaid Services (CMS) and the U.S. Preventive Services Task Force.
• Our work with the Group Health care-delivery system grew. Our researchers have long collaborated with others at Group Health to design and evaluate innovations in care and coverage. But the breadth and depth of this work grew as our research and business goals became better aligned. Results included progress on many Partnership for Innovation (PfI) projects funded through the Group Health Foundation, including those aimed at reducing complications of complex spinal surgery; improving care for cancer patients with limited English proficiency; and testing new approaches to health coaching for obesity.
• Emphasis on patient-centered outcomes research is growing nationally. As of December, GHRI has received seven awards from the Patient-Centered Outcomes Research Institute (PCORI), a new nonprofit agency funding research to help patients, their caregivers, and clinicians get the evidence-based information they need. Our newest PCORI awards focus on reducing risks of chronic opioid therapy, improving care for asthma among minority populations, and helping to expand a health data network.

These recent successes shine light on our best advantage: the ability to conduct practical research for real-world health care decision-making.

The challenges ahead for American health care are huge. Some indications show that health care costs are moderating, but not nearly enough—especially as the population ages and we care for more chronic illness and try to solve behavior-related problems like obesity and its health risks. I’ve heard local pundits declare that the most important news story of 2013 has been the controversy and bumpy startup of the Affordable Care Act or “Obamacare.” I agree and declare simply: We must succeed in achieving more nearly universal coverage in our country.

Our challenge in tackling these issues is to stay on the leading edge of scientific ideas and robust methods—a combination that will keep GHRI’s work both “shovel-ready” and generalizable. We must also keep finding creative ways to embed research into Group Health as it goes about its core business of providing health care and coverage in today’s quickly changing business environment. Doing so will create value for both Group Health patients and the larger health care system.

As NIH Director Dr. Francis Collins says in The Atlantic article, despite American medicine’s funding woes, it is poised “on the brink” for big discoveries “whether it’s in figuring out what to do about cancer, developing a universal vaccine for influenza, or coming up with the strategies to teach us what to do to prevent and cure Alzheimer’s disease.”

We at Group Health are contributing to breakthroughs in all these areas—and more. If the turbulent nature of government funding makes our journey seem difficult, that’s because it is. But our progress is evident, and it’s a journey well work taking.

--Eric B. Larson, MD, MPH
Vice President for Research, Group Health
Executive Director, Group Health Research Institute